AHA 2011: What We Know about Women and Heart Disease

December 2011

The State of the Science Lecture on Women and Heart Disease by Anne Rosenfeld of the Oregon Health Sciences University made it clear that there is much to learn about the ways the disease is unique to women. What we do know indicates that risk, symptoms, progression and treatment of CVD are all substantially different across the genders.

A heart attack is more likely to be lethal for a woman than a man. This is true generally and at 30 days after the event. Non-obstructive coronary artery disease (where arteries are not blocked) is significantly more likely to lead to heart attack or death. A recent study found 40 per cent of women with non-obstructive coronary artery disease had plaque disruption, which can lead to blood clots, restricted blood flow and heart attack.

For both heart attack and heart failure, women tend to be older than men at the time of occurrence and have a lower quality of life.

For both heart attack and heart failure, women tend to be older than men at the time of occurrence and have a lower quality of life. For heart failure, women tend to be sicker but live longer with the condition. Women with heart failure are also less likely to get the proper diagnostic tests. Presented later in the conference, research with Heart Institute participation found that women receiving implantable cardioverter defibrillators for the condition experienced more complications than men and that the approach may be less effective.

Discrepancies in care are also seen more broadly. Rosenfeld explained that women are likely to experience atypical symptoms of heart disease, and patients with atypical symptoms are less likely to receive appropriate treatment. Contributing to these deficiencies is the fact that women remain an under-researched population. Open questions include the controversial topic of hormone replacement therapy.